If you or someone you love is struggling with thoughts of suicide, please call/text the Suicide & Crisis Lifeline at 988. You can also chat at https://988lifeline.org.

In September we recognize two important health holidays: National Suicide Prevention Month and National Alcohol & Drug Addiction Recovery Month. Though at first glance they may seem only tangentially related, suicide and substance misuse are unfortunately close companions. Consider the following:

  • 90% of suicides are carried out by someone with depression, struggling with substance misuse, or a combination of both (Addiction Center)
  • People who use opioids face a 40-60% increase in the likelihood of suicidal thoughts and a 75% increased likelihood of attempting suicide (Addiction Center)
  • Alcohol intoxication is involved in 22% of deaths by suicide in the U.S. (SAMHSA)

There is a strong connection between mental health and substance misuse: NIDA reports that 50% of people with substance use disorder are also managing a mental health issue and vice versa. Whether they’ve been diagnosed or not, people often drink or use drugs to relieve stress or symptoms of mental illness. But using drugs and alcohol to cope usually only has a temporary numbing effect and can end up worsening mental health.

A couple more stats:

  • 90% of people with substance use disorder don’t get treatment (NIDA)
  • 50% of people with suicidal thoughts do not get treatment for mental health (Schreiber et al)

Reasons for avoiding treatment vary, but there is tremendous stigma around both substance misuse and suicide.

To recap: There is a strong relationship between substance misuse and suicide, and it’s not common for people to seek treatment for either. So what can we do about it? Addressing the myths around both conditions may help us be more prepared to support those who need it

Suicide Myths

  • Talking about suicide increases the chance someone will act on it: Talking about suicide improves mental health-related outcomes and the likelihood that someone will seek treatment. It helps people find an alternate view of their circumstances and may reduce suicidal ideation.
  • People who talk about suicide are just seeking attention: If someone talks about feeling suicidal, it’s always important to take them seriously. People who die by suicide have often told someone that they don’t want to live anymore. Be kind and ask if they’re thinking about hurting themselves, if they’re considering suicide, and if they have access to weapons or means of acting on suicidal thoughts. Listen to their answers.
  • Suicide can’t be prevented: Suicide may be unpredictable, but it is preventable. Intervention to treat psychiatric and substance use illnesses can save lives.
  • People who take their own lives are selfish or cowards: Often people who take their own lives are in significant emotional pain and find it difficult to see a way out of their situation. Suicide is frequently associated with complex psychiatric illness like depression, anxiety, bipolar disorder, schizophrenia, and substance misuse.
  • Teenagers and college students are the most at risk for suicide: Suicide is a problem among all ages and groups, but the age group with the highest suicide rate in the U.S. is men and women between 45-64. Men are almost 4 times more likely than women to die by suicide (SAMHSA).
  • Nothing can be done once a person decides to commit suicide: There are several interventions that prevent suicide including having a safety plan and putting up barriers to lethal means.
  • Talk therapy and medications don’t work: One of the best ways to prevent suicide is by getting treatment for mental illness and learning ways to cope with problems. Finding the right treatment can take time, but it can also greatly reduce the risk of suicide.

Substance Abuse Myths

  • Substance misuse is a character flaw or a personal choice: Substance use disorder is a progressive disease that affects the brain and leads to an inability to control drug or alcohol use even when it affects you negatively. Substance misuse can be caused by either genetic or environmental factors, or a combination of both. About half the people with substance use disorder also struggle with mental illness, and vice versa (NIDA).
  • You have to wait until rock bottom to get help: In today’s increasingly dangerous recovery environment, “rock bottom” might be death, especially in the case of opioids or counterfeit drugs made with fentanyl. Recovery starts not when people enter treatment, but when they start to consider their relationship with drugs or alcohol. Reaching out with education and support can make a difference long before hitting rock bottom.
  • You have to want to get better before anyone can help: Only 10% of people who need help reach out, not because they don’t want to get better, but because of fear of stigma, having to go to treatment and/or be abstinent from drugs and alcohol, and underlying behavioral health challenges. Education and support can reach people wherever they are in their journey.

How to Help

If it’s an emergency, please call or text the Suicide & Crisis Lifeline at 988. They’re open 24 hours a day, 7 days a week, and provide free, confidential support. If a loved one is in immediate danger, call 911 or take them to an emergency room right away.

Everyone can help prevent suicide, not just trained mental health professionals. Here’s a few things you can do if the person isn’t in immediate danger:

  • Ask if they are thinking about suicide
  • Listen to them without judgment
  • Acknowledge and talk about their feelings
  • Remove any opportunities they may have to follow through with suicidal plans
  • Follow-up to see how they’re doing and let them know you care
  • Don’t worry about saying the wrong thing
  • Don’t assume that you have the ability to solve their problems
  • Don’t promise that you won’t tell anyone else that they’re considering suicide

If you suspect a loved one is struggling with substance misuse, talk to them about it. Voice your concerns about the long-term impacts of substance abuse and the disease of substance use disorder. Listen to what they have to say, and don’t judge them. Challenge them to get help either for drinking/drug use or for the reasons they say they use substances – it doesn’t mean they have to go into treatment or completely give up drugs or alcohol right now.

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